Zhang Jia-Yu, Huang Jia, Zhao Su-Ya, Liu Xin, Xiong Zhen-Cheng, Yang Zhi-Ying
Graduate School of Peking Union Medical College, Beijing, 100730, People's Republic of China.
Department of General Surgery, China-Japan Friendship Hospital, Beijing, 100029, People's Republic of China.
Risk Manag Healthc Policy. 2021 May 10;14:1897-1906. doi: 10.2147/RMHP.S305332. eCollection 2021.
In order to find the risk factors of postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) according to the latest definition and grading system of International Study Group of Pancreatic Surgery (ISGPS) (version 2016) and propose a nomogram for predicting POPF.
We conducted a retrospective analysis of 232 successive cases of PD performed at our hospital by the same operator from August 2012 to June 2020. POPF was diagnosed in accordance with the latest definition of pancreatic fistula from the ISGPS. The risk factors of POPF were analyzed by univariate and multivariate logistic regression analysis. A nomogram model to predict the risk of POPF was constructed based on significant factors.
There were 18 cases of POPF, accounting for 7.8% of the total. Among them, 17 cases were classified into ISGPF grade B and 1 case was classified into ISGPF grade C. In addition, 35 cases were classified into biochemical leak. Univariate and multivariate analysis showed that hypertension, non-diabetes, no history of abdominal surgery, antecolic gastrojejunostomy and soft pancreas were independent risk factors of POPF. Based on significant factors, a nomogram is plotted to predict the risk of POPF. The C-index of this nomogram to assess prediction accuracy was 0.916 (P < 0.001) indicating good prediction performance.
Hypertension, non-diabetes, no history of abdominal surgery, antecolic gastrojejunostomy and soft pancreas were independent risk factors of POPF. Meanwhile, a nomogram for predicting POPF with good test performance and discriminatory capacity was constituted.
根据国际胰腺手术研究小组（ISGPS）（2016版）最新的定义和分级系统，寻找胰十二指肠切除术（PD）后术后胰瘘（POPF）的危险因素，并提出预测POPF的列线图。
我们对2012年8月至2020年6月在我院由同一手术医生连续进行的232例PD病例进行回顾性分析。POPF根据ISGPS最新的胰瘘定义进行诊断。通过单因素和多因素逻辑回归分析POPF的危险因素。基于显著因素构建预测POPF风险的列线图模型。
有18例POPF，占总数的7.8%。其中，17例被归类为ISGPF B级，1例被归类为ISGPF C级。此外，35例被归类为生化渗漏。单因素和多因素分析显示，高血压、非糖尿病、无腹部手术史、结肠前胃空肠吻合术和胰腺质地柔软是POPF的独立危险因素。基于显著因素，绘制列线图以预测POPF的风险。该列线图评估预测准确性的C指数为0.916（P<0.001），表明预测性能良好。
高血压、非糖尿病、无腹部手术史、结肠前胃空肠吻合术和胰腺质地柔软是POPF的独立危险因素。同时，构建了一个具有良好测试性能和鉴别能力的预测POPF的列线图。
